Ultrasonographic Assessment of Preoperative Metoclopramide on Gastric Volume in Diabetic Patients: A Prospective Controlled Study
| Author | Mahmoud Fawzy Elsharkawy | en |
| Author | Ahmed Ibrahim Ebeed | en |
| Author | Gamal Hendawy Shams | en |
| Author | Mohammad Algyar | en |
| Author | Hameda Beshir | en |
| Author | Daila Ahmed El Sayed El Hefny | en |
| Orcid | Gamal Hendawy Shams [0009-0007-9877-5734] | en |
| Orcid | Mohammad Algyar [0009-0009-5307-2642] | en |
| Orcid | Hameda Beshir [0009-0003-9317-9408] | en |
| Orcid | Daila Ahmed El Sayed El Hefny [0009-0009-0269-6279] | en |
| Issued Date | 2026-06-30 | en |
| Abstract | Background: Diabetic gastroparesis due to autonomic neuropathy and chronic hyperglycemia impairs gastric motility and may persist despite standard preoperative fasting, increasing perioperative aspiration risk. Point-of-care (POC) gastric ultrasound allows objective, real-time bedside assessment of gastric residual volume (GRV) before anesthetic induction. Objectives: This study evaluated whether a single preoperative dose of intravenous (IV) metoclopramide reduces antral cross-sectional area (CSA) and aspiration risk in fasted diabetic patients undergoing elective surgery under general anesthesia. Methods: This prospective, non-randomized controlled study included 60 patients divided into three groups (n = 20 each): Group I (diabetics receiving IV metoclopramide 10 mg, 30 - 60 minutes before ultrasound), Group II (diabetics without intervention), and Group III (non-diabetic controls). After at least 8 hours of fasting, POC gastric ultrasound was performed in semi-sitting (SS) and right lateral decubitus (RLD) positions. The primary outcome was antral CSA (cm²); secondary outcomes included GRV (mL), antral gastric grade (AGG), weight-adjusted GRV (mL/kg), and post-intervention fasting glucose. Results: Antral CSA was lower in metoclopramide-treated diabetics versus untreated diabetics and approached non-diabetic controls. Gastric residual volume decreased in treated versus untreated diabetics and was comparable to controls. Antral gastric grade 0 occurred in 60% of treated diabetics versus 25% of untreated diabetics and 90% of controls (χ² = 17.3, P < 0.001). Grade 2 appeared only in diabetics (10% treated, 20% untreated). Weight-adjusted GRV was lower in treated versus untreated diabetics. Post-intervention fasting glucose differed across groups (P < 0.001). Conclusions: Preoperative IV metoclopramide (10 mg) significantly reduces antral CSA and GRV in fasted diabetic patients, partially normalizing gastric parameters toward non-diabetic levels and lowering aspiration risk. | en |
| DOI | https://doi.org/10.5812/jcma-171078 | en |
| URI | https://brieflands.com/journals/jcma/articles/171078 | en |
| Keyword | Metoclopramide | en |
| Keyword | Gastric Residual Volume | en |
| Keyword | Point-of-Care Ultrasound | en |
| Keyword | Diabetic Gastroparesis | en |
| Keyword | Perioperative Aspiration Risk | en |
| Keyword | Antral Cross-Sectional Area | en |
| Publisher | Brieflands | en |
| Title | Ultrasonographic Assessment of Preoperative Metoclopramide on Gastric Volume in Diabetic Patients: A Prospective Controlled Study | en |
| Type | Research Article | en |
Files
Original bundle
1 - 1 of 1
Loading...
- Name:
- jcma-11-2-171078-publish-pdf.pdf
- Size:
- 426.74 KB
- Format:
- Adobe Portable Document Format
- Description:
- Article/s PDF